Evidence mapPaperPMID 42359611Full record

ArticleJournal of cardiovascular pharmacology2026

SGLT2 Inhibitors Attenuate Neutrophil-Mediated Endothelial Injury in Coronary Artery Disease With Type 2 Diabetes Mellitus Through a GREM1-Associated Smad Signaling Axis.

Wenyuan Zheng, Yixin Zhou, Bozhi Ye, Shiyu Hu, Jian Zhang, Zhenwei Li, Xiaomin Chen, Jiatian Cao, Juying Qian, Junbo Ge

Abstract read
In one paragraph

Article in Journal of cardiovascular pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Wenyuan ZhengDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Key Laboratory of Viral Heart Diseases, National Health Commission, Chinese Academy of Medical Sciences, Shanghai, China.
Yixin ZhouThe Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China ; and.
Bozhi YeThe Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China ; and.
Shiyu HuDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Key Laboratory of Viral Heart Diseases, National Health Commission, Chinese Academy of Medical Sciences, Shanghai, China.
Jian ZhangDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Key Laboratory of Viral Heart Diseases, National Health Commission, Chinese Academy of Medical Sciences, Shanghai, China.
Zhenwei LiThe Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, China .
Xiaomin ChenThe Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, China .
Jiatian CaoDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Key Laboratory of Viral Heart Diseases, National Health Commission, Chinese Academy of Medical Sciences, Shanghai, China.
Juying QianDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Key Laboratory of Viral Heart Diseases, National Health Commission, Chinese Academy of Medical Sciences, Shanghai, China.ORCID 0000-0002-7512-3692
Junbo GeDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Key Laboratory of Viral Heart Diseases, National Health Commission, Chinese Academy of Medical Sciences, Shanghai, China.

Funding

Grant of Shanghai Municipal Health Commission 2022JC012Grant of Zhongshan Hospital Affiliated to Fudan University 2023ZSFZ43National Natural Science Foundation of China 82070320National Natural Science Foundation of China 82470338National Program on Key Basic Research Project of China 2023YFC2506500Shanghai Science and Technology Commission 25SF1902100
6 · The paper itself

Abstract

abstractType 2 diabetes mellitus (T2DM) is a critical risk factor for coronary artery disease (CAD), with neutrophils contributing to CAD through acute inflammatory responses. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors offer cardiovascular benefits beyond glycemic control, but their mechanisms involving innate immunity and neutrophil function in T2DM-related CAD remain unclear. Neutrophils were isolated from healthy controls, patients with CAD and T2DM, and patients receiving SGLT2 inhibitor therapy. Bulk transcriptomic analysis, flow cytometry, ELISA, and western blotting were used to assess gene expression, signaling changes, and neutrophil activation. Co-cultures of neutrophils with luciferase-expressing human aortic endothelial cells (HAEC-Luc) assessed endothelial injury, and a diabetic rat model was used to assess in vivo cardiac injury. Results showed elevated peripheral neutrophil cell-free dsDNA, elastase 2, and GREM1 expression in patients with T2DM-CAD, reversed by SGLT-2 inhibitors. T2DM-CAD neutrophils induced significant endothelial injury, ameliorated by SGLT-2 inhibition, or GREM1 blockade. Mechanistically, SGLT-2 inhibitors suppressed GREM1, restored TGF-β/Smad signaling, and reduced neutrophil-mediated cytotoxicity. In vivo, SGLT-2 inhibitors alleviated cardiac damage in diabetic rat, with suppressed neutrophil activation and upregulated TGF-β signaling. Our findings suggest that increased GREM1 expression in neutrophils is associated with impaired Smad1/5/9-related signaling and enhanced endothelial injury in T2DM-CAD, and SGLT-2 inhibitors exert vascular protection through GREM1 downregulation and TGF-β/Smad pathway modulation, highlighting a novel immunoregulatory mechanism with translational potential for diabetic cardiovascular outcomes.

Indexed as

Coronary Artery DiseaseDiabetes Mellitus, Type 2Endothelial CellsNeutrophilsSmad ProteinsSmad Proteins, Receptor-RegulatedSodium-Glucose Transporter 2 InhibitorsAnimalsCase-Control StudiesCells, CulturedCoculture TechniquesDiabetes Mellitus, ExperimentalFemaleHumansMaleMiddle AgedSmad ProteinsSmad Proteins, Receptor-RegulatedSodium-Glucose Transporter 2 Inhibitorscoronary artery diseaseGREM1neutrophilsodium–glucose cotransporter 2 (SGLT-2) inhibitorTGF-βtype 2 diabetes mellitus

Identifiers

PMID42359611
PMCPMC13344405

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.